Basic Information
Provider Information
NPI: 1003139650
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: ERIN
MiddleName: EMILY
NamePrefix:  
NameSuffix:  
Credential: MSW, PPSC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4888 CLAYTON RD APT 5
Address2:  
City: CONCORD
State: CA
PostalCode: 945213025
CountryCode: US
TelephoneNumber: 4085060946
FaxNumber:  
Practice Location
Address1: 2730 SALVIO ST
Address2: ALLIANCE PROGRAM
City: CONCORD
State: CA
PostalCode: 945192599
CountryCode: US
TelephoneNumber: 9256870374
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/10/2010
LastUpdateDate: 11/16/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041S0200X  Y Behavioral Health & Social Service ProvidersSocial WorkerSchool

No ID Information.


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